Provider Demographics
NPI:1003852575
Name:EUGENIO A AGUILAR III MD PA
Entity Type:Organization
Organization Name:EUGENIO A AGUILAR III MD PA
Other - Org Name:ERMOSA CENTRE
Other - Org Type:Doing Business As
Authorized Official - Title/Position:SURGICAL DIRECTOR
Authorized Official - Prefix:DR
Authorized Official - First Name:EUGENIO
Authorized Official - Middle Name:A
Authorized Official - Last Name:AGUILAR
Authorized Official - Suffix:III
Authorized Official - Credentials:MD
Authorized Official - Phone:713-797-0085
Mailing Address - Street 1:6410 FANNIN ST
Mailing Address - Street 2:SUITE 927
Mailing Address - City:HOUSTON
Mailing Address - State:TX
Mailing Address - Zip Code:77030-3000
Mailing Address - Country:US
Mailing Address - Phone:713-797-0085
Mailing Address - Fax:713-797-0694
Practice Address - Street 1:6410 FANNIN ST
Practice Address - Street 2:SUITE 927
Practice Address - City:HOUSTON
Practice Address - State:TX
Practice Address - Zip Code:77030-3000
Practice Address - Country:US
Practice Address - Phone:713-797-0085
Practice Address - Fax:713-797-0694
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2006-06-21
Last Update Date:2008-07-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TXF3696208200000X
TX261QA1903X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes261QA1903XAmbulatory Health Care FacilitiesClinic/CenterAmbulatory Surgical
No208200000XAllopathic & Osteopathic PhysiciansPlastic SurgeryGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
TX0834S0901Medicaid